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Ep #471: Reimagining the Future of Healthcare: No Deductibles and Copays - with James Millaway
Imagine a future where health plans come with no deductibles and no copays, doesn't it seem like a fantasy? But what if it's not? In our enlightening conversation with James Millaway, the CEO of Zero Health, we unpack the concept of health plans without the burden of deductibles and copays. We trace the history of these cost-sharing measures and their effect on overall healthcare costs. We also highlight the idea of insurance and how it should be a guard against catastrophic risks, not everyday events.
Moving onto the second half of our discussion, we delve into the realm of efficient healthcare purchasing and its potential for significant cost savings. We ponder on how employers and brokers can enable their employees to make informed decisions about their care. The talk also covers the integration of care management and the potential savings in medical expenditure. Our discussion reaches its peak as we talk about the future of healthcare and the vital role of trust. We explore Zero Health's impact on this future, and the importance of creating a trustworthy product. Don't miss out on this insightful conversation where we reimagine the future of healthcare.
Ep #470: Revealing the Hidden Layers of Healthcare Costs - with Dr. Keith Smith
Have you ever wondered about the hidden layers of healthcare costs? Today, we bring you insights from an eye-opening conversation with Dr. Keith Smith, co-founder of the Surgery Center of Oklahoma. Dr. Smith shares his personal journey of navigating the healthcare industry, and the shocking discovery that hospitals were not always the best advocates for patients or surgeons. He and his colleague dared to change this by establishing their own facility, a radical move that influenced the Trump Executive Order Mandating Price Transparency.
We're also discussing the rising trend of self-funded healthcare plans and why employers are looking for alternatives to traditional ones. Imagine a zero-deductible and zero-copay approach to healthcare; it's happening, and it's giving companies a competitive advantage in the labor market. But it's not all smooth sailing; there are important regulations to consider like CAA notifications and ERISA. Plus, we highlight why quality assurance remains crucial when choosing healthcare facilities.
Rounding off, we question traditional quality metrics and argue for the value of price transparency in measuring the quality of care. We draw on insights from Marty McCary's book Unaccountable to challenge the reliability of existing quality metrics. Finally, Dr. Smith shares his thoughts on the future of healthcare and the ongoing need for more transparency and patient advocacy. So, sit back and join us for a compelling discussion filled with revelations about the evolving healthcare industry.
Ep #469: Pharmacy Benefit Management Unraveled: From Pricing to Genomics - with Dave Parker
Ever wondered how the Pharmacy Benefit Management (PBM) industry really works? Join us for an enlightening chat with our guest, Dave Parker, the Vice President of Sales and Marketing at TrueScript, as we unravel the intricacies of the traditional PBM relationship. Gain insight as Dave dissects key terms like average wholesale price and net cost, and unveils the ways PBMs make their money. We also delve into the trend of manufacturers moving closer to employers to shake off spread pricing models. More importantly, discover why it’s crucial to ask the right questions in a PBM relationship.
We also step into the fascinating world of pharmacogenomics testing for prescription drugs, a game-changing approach that could redefine the healthcare industry. Picture this - a one-time test that prevents the misprescribing of medications, saving patients and doctors from hefty medical bills and hospital stays. Indeed, such a test already exists, and some PBMs are benefiting from the potential savings it brings. We’ll also investigate the prospect of making this a routine test for newborns and what it could mean for stop loss carriers. Last but not least, Dave returns to introduce us to the emergence of transparent PBMs - a revolutionary shift that is transforming the industry and proving particularly appealing to younger consumers. Tune in for an episode packed with industry insights and thought-provoking discussions.
Ep #468: The Journey and Implications of Direct Primary Care - with Dr. Kyle Rickner
Prepare yourself to be fascinated by Dr. Kyle Rickner, co-founder and chairman at Primary Health Partners, as he takes us on an inspiring journey of how direct primary care became his answer to physician burnout and subpar patient experiences. Step into the world of evolving healthcare models as we dissect the barriers that prevent more physicians from transitioning to this progressive model. Together, we untangle the web of the traditional fee-for-service system and how it has stagnated the growth of direct primary care. We also unpack the implications of misused health insurance and sky-rocketing premiums leading to a precarious cycle of healthcare costs.
In the latter half of our enlightening conversation, we journey across state lines to understand how direct primary care physicians unite in their mission to deliver patient care. Listen to Dr. Rickner narrate the challenges and triumphs of coordinating care for a substantial client base, all while pushing the scalability model forward. We also shine a spotlight on the significance of data collection in establishing the value of direct primary care and highlight the urgent need for educating people about its benefits. Join us and share our curiosity, as we discover how direct primary care is revolutionizing the healthcare industry.
Ep #467: A Deep Dive into the World of Healthcare Costs - with Kelly McDevitt
Ever wondered if your business is really understanding the true cost of healthcare? Join us as we pick the brain of Kelly McDevitt, the President of the Nonprofit Integrated Benefits Institute (IBI). With a whopping 40 years of industry experience, Kelly unpacks how IBI assists businesses in deciphering the often-complex healthcare costs beyond just medical and pharmacy expenses. We dive into the increasing curiosity around self-insured plans and the pivotal role of data in employer decision-making. Plus, you'll discover how IBI’s benchmarking data provides a panoramic view, setting the stage for strategic planning.
Then, as the conversation deepens, we navigate the murky waters of delayed healthcare and the difficulties it presents in sourcing relevant claims data. Our journey takes us into the heart of the pandemic's impacts on health and disability claims - including prolonged health issues related to COVID-19. Kelly sheds light on how businesses can utilize this data to craft well-informed decisions, the significance of benchmarking, and the unique challenges HR teams are currently facing. Tune in for an insightful conversation packed with valuable insights for employers seeking to understand the labyrinth of healthcare costs.
Ep #466: 48 Employees Walked Out: Lessons Learned- with Kristen Hadeed
Have you ever wondered about the balance between empowering employees and maintaining control as a leader? Get your answers as we have an enlightening conversation with Kristen Hadeed, author of Permission to Screw Up and Leadership Thought Leader. Kristen takes us on her leadership journey, a journey that began when she was 21 and saw 45 of her employees walk out on her, a pivotal event that reshaped her leadership approach. She shares how this experience transformed her into an advocate for fostering an environment of trust, empowerment, and psychological safety.
What if your team could solve problems without micromanagement? Would it be more effective? Kristen takes a deep dive into these questions and unravels the delicate balance between supporting employees and giving them ownership of their work. She also shares her insights on how to avoid micromanagement and the impact it can have on your team’s morale and your own wellbeing. At the heart of her message is the importance of cultivating a culture of trust that encourages constructive feedback.
Can vulnerability be a game-changer in the workplace? Let's find out from Kristen's personal experience. She unveils how her honesty and vulnerability with her team not only led them to trust her but also gave her a second chance. Listen in as she passionately talks about the value of fostering an environment of vulnerability in the workplace. You'll learn the importance of striking a balance between guiding and supporting employees and giving them ownership of their work. It's time to explore the creation of human workplaces where vulnerability is embraced. This episode is loaded with wisdom, practical advice and a fresh perspective on leadership. Don't miss out!
GET KRISTEN'S BOOK: Permission To Screw Up
I never miss a week of the latest Saltzman interviews!
David’s way of just letting his guest talk is the absolute only way a podcast interview should be done. He highlights his guests each week and makes the conversation truly enjoyable for the listener to digest. Keep rocking rockstar!
In Depth Discussions on Benefits Topics & More
An interesting take on the dynamics occurring today within businesses. If you're looking to deep dive on topics like retirement data, benefits, data security, healthcare and hear directly from folks in the trenches, you should definitely give this a listen.
Best source for leading edge benefits information
If CMS/HHS listened to a small portion of these they would start understanding that the broker community has real solutions to the healthcare morass. Alas, I’m not sure they’re interested in solutions as much as they serving their own agendas. In any case, this is what I have found to be the best source for leading edge benefits solutions. I get more out of this than all the benefits publications combined. Superb job, Mr, Saltzman!